A key part of the Affordable Care Act will be implemented by executive order in Kentucky if the healthcare law is upheld by the U.S. Supreme Court. Exchanges in which residents can purchase insurance are a major part of the law. Each state must have an exchange, and if states don't set them up, the federal government will.

Governor Steve Beshear says he will sign an executive order to create a state-run exchange if the law is upheld.

Beshear says many state healthcare and business organizations encouraged him to act to allow Kentucky to control its own exchange, which must be active by the end of this year.

“While no one can predict what the Supreme Court will ultimately decide, it is imperative that the state prepare for any decision,” Beshear says. “The steps we have taken to date, and the planning process we are putting in place helps ensure the state is able and ready to follow the law, if upheld, and also guarantees we don’t have the federal government running our insurance market.”

So far, Kentucky has received more than $60 million in grant money from the federal government to implement the federal law. Legislators also put an additional $50 million in the state budget to implement the law's new Medicaid regulations.